Category: New Technology: Stones

MP5-6 - Dusting Efficiency Comparison between Moses Technology of Ho:YAG Laser and SuperPulse Thulium Fiber Laser

Fri, Sep 21
10:00 AM - 12:00 PM

Introduction & Objective :

At present, the Ho:YAG laser is the most commonly used laser  for treating  urolithiasis. A new technology of the Ho:YAG laser – Moses technology – was designed to increase ablation efficiency and to reduce stone retropulsion. Recently, a thulium fiber laser (TFL) has been suggested as an alternative laser source, with a potential for higher ablative efficiency and lower retropulsion. The aim of this study was to compare the efficiency of stone dusting between a Ho:YAG laser with Moses technology and a SuperPulse TFL.


Methods : A SuperPulse TFL generator was compared to a Ho:YAG laser generator with Moses technology. 200 µm fibers were used in all experiments. Laser lithotripsy was performed with a flexible ureteroscope (Pusen) for direct vision and fiber control. Uric acid stones were used in this study. Irrigation pressure was 40 cm H2O. Lithotripsy was performed in a specially constructed vessel of 13 mm in diameter, with 2 mm holes drilled in the walls at a height of 40 mm to allow collection of stone dust from irrigation overflow. The laser parameters for both systems were 0.2 J and 80 Hz (16 W). Lithotripsy was performed during 2’30’’. After lithotripsy, the solution from the outer cuvette was filtered through filter paper with a pore size of 2 µm allowing stone dust collection. The weight of stone dust was calculated as the difference between weight of the dried filter with the stone dust and the initial weight of the filter. Experiments were repeated 5 times.


Results :

Initial stone mass was 210±24 mg. The weight of stone dust after lithotripsy was 69±32 mg for Ho:YAG laser lithotripsy with Moses technology and 138±25 mg for the SuperPulse TFL. 


Conclusions :

The SuperPulse TFL produced twice as much stone dust as the Ho:YAG laser with Moses technology. When these promising results are confirmed in future studies, the SuperPulse TFL may be able to significantly reduce operating times.

Vincent De Coninck

Urologist
AZ Klina
Brasschaat, Antwerpen, Belgium

Vincent De Coninck graduated as a medical doctor from the Free University of Brussels, Belgium (VUB) in 2011. He became a certified urologist in 2017 after a training at the University Hospital of Brussels (Prof. Dr. Dirk Michielsen) and OLV Aalst (Prof. Dr. Alex Mottrie), where he developed a special interest in the minimal invasive treatment of benign and malignant pathologies. In the same year, he became Fellow of the European Board of Urology.
In 2018, he completed a one-year fellowship program of the Endourological Society in Paris, France under the supervision of Prof. Dr. Olivier Traxer. During that fellowship, he also obtained a diploma in urolithiasis, organized by Dr. Michel Daudon at the Sorbonne University in Paris, France. Afterwards, he was trained in HoLEP by Dr. Karin Lehrich in Berlin, Germany.
Currently, he is completing a three-month fellowship under the supervision of Dr. Guido Giusti in Milan, Italy. In December 2018, he will start working as an endourologist in AZ Klina, Brasschaat, Belgium. He will focus on the medical and surgical treatment of kidney stones and benign prostatic obstruction (HoLEP) and he will continue publishing articles relating to the management of patients with renal stone disease.

Etienne X. Keller

Fellow of the ES
Sorbonne Université, GRC n°20, Groupe de Recherche Clinique sur la Lithiase Urinaire, AP-HP, Hôpital Tenon, F-75020 Paris, France
Paris, Ile-de-France, France

Paul H.L. Chiron

MD, FEBU
Sorbonne Université, GRC n°20, Groupe de Recherche Clinique sur la Lithiase Urinaire, AP-HP, Hôpital Tenon, F-75020 Paris, France
Saint Mandé, Ile-de-France, France

Anastasiia Kovalenko

National Research Nuclear University MEPhI, Moscow, Russia
Moscow, Moskva, Russia

Viktoriya Andreeva

Engineer
Moscow Engineering Physics Institute
Moscow, Moskva, Russia

Viktoriia Andreeva
Engineer, National Research Nuclear University Moscow Engineering Physical Institute

Olivier O. Traxer

Professor
Sorbonne Universite, GRC n020 Lithiase Renale, AP-HP, Hospital Tenon, F-75020 Paris, France
Paris, Ile-de-France, France